Perforations in visceral walls may be formed to gain access to adjacent structures of the body, the methods commonly referred to as transluminal procedures. For example, culdoscopy was developed over 70 years ago, and involves transvaginally accessing the peritoneal cavity by forming a perforation in the cul de sac. This access to the peritoneal cavity allows medical professionals to visually inspect numerous anatomical structures, as well as perform various procedures such as biopsies or other operations. Many transluminal procedures for gaining access to different body cavities using other bodily lumens are also being developed.
Generally, transluminal procedures require the use of several different medical instruments, and therefore can be time consuming. At a minimum, a cutting instrument is first used to form the perforation, an endoscope or other visualizing device is used to inspect the area or otherwise perform some procedure, and then one or more closure instruments are used to close the perforation. There is also the risk of perforating structures that lie just beyond the bodily wall being cut. For example, when incising the gastric wall, the potential of hitting blood vessels without knowing could lead to bleeding complications. Accidentally puncturing the small intestines could lead to the spillage of bacteria into the peritoneal cavity. Depending on the structure being cut, it has also proven difficult to adequately close the perforation and prevent leakage of bodily fluids to reduce the risk of infection. For example, anastomotic leaks are seen in up to 10% of laparoscopic gastrojejunostomies.